scholarly journals Evaluation of intracranial vessel wall MR imaging, CT angiography, and MR angiography in patients with clinically diagnosed CNS vasculitis.

2020 ◽  
Author(s):  
Thomas Flood
Keyword(s):  
Mr Imaging ◽  
Ct Angiography ◽  
Vessel Wall ◽  
Mr Angiography ◽  
Cns Vasculitis ◽  
Intracranial Vessel

Abstract WMP55: Vessel Wall Characteristics using High Resolution Magnetic Resonance Imaging in Reversible Cerebral Vasoconstriction Syndrome and Central Nervous System Vasculitis

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Russell Cerejo ◽  
Seby John ◽  
Tariq Hammad ◽  
Emmanuel C. Obusez ◽  
Rula Hajj-ali ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Central Nervous System ◽  
Vessel Wall ◽  
Clinical Presentation ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Cns Vasculitis ◽  
Cerebral Vasoconstriction ◽  
Intracranial Vessel ◽  
Vessel Stenosis

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) and central nervous system (CNS) vasculitis often have similar initial clinical presentation, laboratory findings and imaging features creating a diagnostic dilemma. High-resolution-3-Tesla Magnetic Resonance Imaging with Gadolinium contrast (HR-MRI) is a non-invasive method to look at intracranial vessel wall characteristics. Methods: A retrospective analysis of all patients with a diagnosis of RCVS or CNS vasculitis that underwent HR-MRI at our institution was performed. Inclusion criteria for RCVS were clinical presentation, no aneurysmal subarachnoid hemorrhage, normal cerebrospinal fluid and reversible multifocal intracranial vessel stenosis whereas criteria for CNS vasculitis were cases with positive brain biopsy or typical clinical presentation, course and laboratory markers with rheumatology and stroke neurology agreement in diagnosis. Demographics, clinical presentation, laboratory testing, imaging studies and outcomes were collected. Results: Eleven patients with RCVS [10 (90.9%) females, mean age 45.2] and 8 with CNS vasculitis [6 primary CNS vasculitis, 6 (75%) males, mean age 43.5] were included in the study. No abnormal vessel wall enhancement or thickening was seen in any of the RCVS patients in areas of vessel stenosis. Six (75%) of CNS vasculitis patients had vessel wall thickening or enhancement (p=0.001 for comparison to RCVS) and the remaining 2 patients had HR-MRI performed 6 and 10 years after diagnosis and chronic treatment. All RCVS patients who had follow up HR-MRI demonstrated resolution of the multifocal stenosis. Two out of 4 CNS vasculitis patients with subsequent HR-MRI imaging had decrease in vessel wall thickening and enhancement after immunosuppressive therapy. Conclusion: In acute stages of presentation, HR-MRI may be useful in differentiating RCVS from CNS vasculitis. It may also be useful in following the disease course to look for resolution of intracranial vessel stenosis in RCVS or treatment response in vasculitis. Further studies are needed to confirm the utility of HR-MRI in diagnosis and disease progression in RCVS and vasculitis.

Intracranial vessel wall MR imaging of an intradural vertebral artery dissection

2020 ◽  
Vol 68 ◽  
pp. 108-110 ◽  
Author(s):  
Kofi-Buaku Atsina ◽  
Aaron Rothstein ◽  
Steven R. Messé ◽  
Jae W. Song
Keyword(s):  
Mr Imaging ◽  
Vertebral Artery ◽  
Vessel Wall ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Intracranial Vessel

Neuroradiological findings in adult cranially conjoined twins

1998 ◽  
Vol 89 (4) ◽  
pp. 635-639 ◽  
Author(s):  
Olav Jansen ◽  
V. A. Mehrabi ◽  
Klaus Sartor
Keyword(s):  
Mr Imaging ◽  
Ct Angiography ◽  
Mr Angiography ◽  
Cross Flow ◽  
Conjoined Twins ◽  
Radiological Anatomy ◽  
Content Type ◽  
Temporal Lobes ◽  
Sagittal Sinus ◽  
Fine Print

✓ The authors demonstrate the radiological anatomy and review the accepted embryological theories in a case of total craniopagus. These 24-year-old female cranially conjoined twins were studied with computerized tomography (CT) and CT angiography, magnetic resonance (MR) imaging and MR angiography as well as selective arterial digital subtraction (DS) angiography to clarify whether surgical separation was possible. The neuroradiological findings are discussed, taking into consideration both the embryological and surgical literature. The malformation was classified as a total parietooccipitotemporal craniopagus. Whereas CT angiography and MR imaging including MR angiography demonstrated a common superior sagittal sinus, only selective arterial DS angiography revealed a significant arterial and venous cross-flow between the two adjacent temporal lobes. Selective intraarterial DS angiography is required in the neuroradiological evaluation of complex malformations, even when the anatomy of brain and skull can be well demonstrated with high-quality MR and CT studies.

Subarachnoid hemorrhage without evident cause on initial angiography studies: diagnostic yield of subsequent angiography and other neuroimaging tests

2003 ◽  
Vol 98 (6) ◽  
pp. 1235-1240 ◽  
Author(s):  
Mehmet A. Topcuoglu ◽  
Christopher S. Ogilvy ◽  
Bob S. Carter ◽  
Ferdinando S. Buonanno ◽  
Walter J. Koroshetz ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Mr Imaging ◽  
Ct Angiography ◽  
Mr Angiography ◽  
Diagnostic Yield ◽  
Catheter Angiography ◽  
Content Type ◽  
Spine Mr ◽  
Susceptibility Contrast ◽  
Fine Print

Object. The aim of this study was to assess the diagnostic yield of imaging tests performed in patients in whom the cause of subarachnoid hemorrhage (SAH) had not been demonstrated on initial angiography. Methods. By reviewing medical records of 806 patients with SAH who had been admitted during a 6.5-year period, the authors identified 86 in whom initial transfemoral catheter angiography failed to reveal the cause of SAH. Clinical and radiological data were analyzed to determine the diagnostic yield of subsequent catheter angiography, computerized tomography (CT) angiography, magnetic resonance (MR) angiography, and MR imaging of the brain and spine for various subtypes of SAH (bleeding not visualized on CT studies [CT-negative SAH], perimesencephalic SAH, and nonperimesencephalic SAH). Of 41 patients with nonperimesencephalic SAH, 36, 32, and 21 underwent repeated catheter angiography, CT angiography, and MR angiography, respectively; brain MR imaging was performed in 23 patients (18 with Gd and 15 with susceptibility contrast sequences), and spine MR imaging in 17. Of 36 patients with perimesencephalic SAH, 31, 23, and 17 underwent repeated catheter angiography, CT angiography, and MR angiography, respectively; brain MR imaging was performed in 18 patients (17 with Gd and 11 with susceptibility contrast sequences), and spine MR imaging in 14. Of nine patients with SAH not visualized on CT scanning, three, one, and six underwent repeated catheter angiography, CT angiography, and MR angiography, respectively; brain MR imaging was performed in eight patients (five with Gd and three with susceptibility contrast sequences), and spine MR imaging in seven. The cause of SAH could be determined in only four patients, all with nonperimesencephalic SAH. The only test that yielded a diagnosis was catheter angiography (three aneurysms on the second and one on the third angiography, all surgically secured). Diffusion-weighted MR imaging demonstrated small, deep infarcts in five patients. Conclusions. Repeated catheter angiography remains the most sensitive test to determine the cause of SAH that is not demonstrated on initial angiography, particularly in the subtype of nonperimesencephalic SAH. Newer, noninvasive imaging techniques provide little diagnostic yield.

Detection of Angiographically Occult Ruptured Basilar Sidewall Perforator Aneurysm by Vessel Wall MR Imaging

2020 ◽  
pp. 194187442096364
Author(s):  
Mougnyan Cox ◽  
Jae W. Song ◽  
Seyed Ali Nabavizadeh ◽  
David Kung ◽  
Laurie Loevner ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Basilar Artery ◽  
Vessel Wall ◽  
Imaging Techniques ◽  
Artery Aneurysm ◽  
High Morbidity ◽  
Computed Tomographic ◽  
Ruptured Aneurysms ◽  
Intracranial Vessel ◽  
The Right

Basilar artery perforator aneurysms are rare with a prevalence of less than 1%. These are particularly challenging to detect given their small size and tendency to intermittently thrombose. We describe a case of a ruptured basilar artery sidewall perforator aneurysm that was angiographically occult on computed tomographic angiogram and cerebral catheter angiogram. One day after the initial diagnostic work-up, intracranial vessel wall MR imaging (VWI) was performed which revealed a small outpouching along the right posterolateral basilar arterial wall with a punctate enhancing focus suggestive of a thrombosed basilar perforator artery aneurysm. Thrombus within the small aneurysm sac likely contributed to the poor opacification of the aneurysm sac on conventional lumen-based imaging techniques. Ruptured aneurysms have high morbidity and mortality due to their tendency to rebleed, making their expedient detection and treatment imperative. This case highlights the role VWI can play in detecting small ruptured aneurysms that intermittently thrombose and are otherwise challenging to diagnose with conventional vessel imaging.

Value of vessel wall magnetic resonance imaging in the diagnosis and management of cerebrovascular diseases

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hany M Zaki El-Dine ◽  
Yasser A Abbas ◽  
Mohammad K Elewa ◽  
Sherien M Farag ◽  
Khaled E Mohamad
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Mr Imaging ◽  
Vessel Wall ◽  
Intracranial Stenosis ◽  
Intracranial Atherosclerosis ◽  
Cns Vasculitis ◽  
Moya Moya Disease ◽  
Increased Risk ◽  
Significant Difference

Abstract Background Intracranial atherosclerosis, one of the leading causes of ischemic stroke, is associated with an increased risk for recurrent stroke and dementia. Objective This work was carried out to assess suspicious lesions detected by Magnetic Resonance Angiography (MRA) and Computed Tomgraphy Angiography (CTA) for further evaluation by vessel wall MRI . Patients and methods This study was conducted on 16 patients who were admitted to Ain Shams University Specialized Hospital with establilished diagnosis of stroke (11 patients with intracranial atherosclerosis, 3 patients with CNS vasculitis and 2 patients with Moya-moya disease ) performing MRI brain including magnetic resonance angiography (MRA) that showed intracranial stenosis, who then referred to Misr Radiology Center for the evaluation of intracranial vasculopathies by vessel wall MR Imaging using 3.0-tesla (T) field strengths. Results The results showed statistically significant difference between groups as regard to significant intracranial stenosis (>50%). It was prominent among moya moya disease group (100.0%) followed by intracranial atherosclerotic groups (81.8%), whereas CNS vasculitis group shows mild intracranial stenosis (0.0%). Conclusion Intracranial vessel wall MR imaging is an adjunct to conventional angiographic imaging

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